Impact of periodontitis on the Oral Health Impact Profile: A systematic review and meta-analysis

Background: Periodontitis, being a chronic and multifactorial disease, affects oral health, and consequently, the patient's quality of life (QoL). The assessment of the oral health-related quality of life (OHRQoL) is possible with the Oral Health Impact Profile-14 (OHIP-14) questionnaire comprising 7 subdomains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap.

Objectives: The aim of this study was to conduct a systematic review of cross-sectional or case-control studies concerning the impact of periodontitis on QoL measured with OHIP-14. The outcomes of the studies were subjected to a meta-analysis.

Material and methods: On the basis of a survey of databases (MEDLINE, Scopus, Google Scholar, and Polish Medical Bibliography - PBL), 1,346 titles related thematically to the impact of periodontitis on QoL were obtained and analyzed. Ten studies were considered eligible for evaluation (8 cross-sectional ones and 2 case-control ones).

Results: All studies indicated a significant influence of periodontitis on the deterioration of the OHIP-14 values. This relationship was shown to be directly modified in proportion to the degree of the advancement of the periodontal disease and to the extent of periodontal tissue damage. Our own meta-analysis confirmed the correlation between the prevalence of periodontitis and increased OHIP-14 scores with a cumulative odds ratio (OR) of 1.33, demonstrated a moderately significant deterioration of the OHIP-14 scores by 4.2 points in the group with periodontitis as compared to the control group, and assessed the probability of OHIP-14 deterioration to be 3.5 times greater in severe periodontitis.

Conclusions: The impact of periodontitis on the deterioration of OHRQoL is quite clearly explained by the clinical symptoms of periodontitis. According to patients, the most important problems that periodontitis may cause include psychological discomfort, stress, problems in interpersonal relations, or even difficulties in daily activities. This indicates the need for more of a holistic approach in planning the goals of the periodontal therapy, taking into account the psychological and social aspects of the patient's perception of the disease.